Project Abstract: Breast reconstruction after mastectomy is an important treatment for women with breast cancer. However, there is virtually no information about whether there is unmet need for reconstructive surgery after the initial treatment period. The goal of this study is to examine the decision-making process of breast cancer reconstruction after the initial diagnosis and treatment period. The specific aims of the proposed study are: 1) to perform a survey of a population-based cohort of women diagnosed with breast cancer from August 2005 to June 2006 in the metropolitan area of Los Angeles who received a mastectomy, and to measure the proportion of women undergoing delayed breast reconstruction;2) to describe correlates of receipt of immediate and delayed breast reconstruction compared to those women who have not been reconstructed;3) to evaluate decisional satisfaction and health-related quality of life (HRQL) in women who did and did not receive immediate or delayed breast reconstruction and 4) to develop measures and describe the stages in the decision- making process for breast reconstruction. The methodology will be a cross-sectional survey of 500 breast cancer patients from the Los Angeles SEER registry who were treated with a mastectomy. The results of this exploratory study will improve informed decision-making regarding breast cancer reconstruction by evaluating barriers to and unmet need for treatment. The results will also be used to design a larger study across SEER registries. PUBLIC HEALTH RELEVANCE: Breast reconstruction after mastectomy is an important treatment for women with breast cancer. However, there is virtually no information about whether there is unmet need for reconstructive surgery after the initial treatment period. The goal of this study is to examine the decision-making process of breast cancer reconstruction after the initial diagnosis and treatment period. The results of this exploratory study will improve informed decision-making regarding breast cancer reconstruction by evaluating barriers to and unmet need for treatment